Work No.

___________ Date _________

Sheet Nos. __________________________________________
If all sheets, write all. If specific sheets, write sheet numbers.

Independent Quantity Verification

I hereby certify that I have calculated the initial set of quantities

for the sheets indicated.
_________________________ ________________________
Print Name Signature

I hereby certify that I have calculated an additional independent

set of quantities for the sheets indicated and that any
discrepancies between the two (2) sets of quantities have been
resolved. Both sets of calculations will be supplied to the Water
Department if requested.
_________________________ ________________________
Print Name Signature